Here’s the second of the four chapters that are free for everyone. The remainder of the memoir will be available to paid subscribers, so if you like what you read in the first chapters, please feel free to join - BTW - I’m offering a 50% off discount right now.
I’m still not sure of the title, so for now I’m calling it:
Memoir of a Cancer Created Introvert.
Chapter 2
Journal Entry
June 3rd, 2021
New information is coming at me in an almost endless stream. My primary care doctor sent me to a hematologist named Dr. Adams* because my white count keeps dropping. Right now, it’s at 1.7 when the normal range is 3.9-11.7. This appointment made me nervous. He focused almost forty-five minutes on my family history and symptoms. He told me a lot about blood disorders and what he’s looking for. He wants me to have a bone marrow biopsy to rule out MDS like Dad had. When I left, I stopped at the grocery store. While I was in the middle of the produce department, the doctor called me to say I definitely need to have the bone marrow biopsy as soon as possible because preliminary blood work showed my white blood count is down to 1.5. He’s had the office schedule the biopsy at the hospital on 6/22. He also prescribed iron and B-12. I have to admit I’m really scared. I’ll try not to let it show to other people. But it kind of puts everything into a new perspective. What do I want to focus on?
I almost didn’t answer the phone because I didn’t recognize the number.
“Hello, this is Dr. Adams from Riverside Cancer Center.”
“Hello Dr. Adams,” I said. “How are you today?”
Yep, I’m a southern girl. It’s bad manners not to inquire about other people.
“I’m doing fine. I’m calling because we just got back some additional results from the bloodwork we did on June 3rd.”
Then he got quiet.
I figured he was waiting for me to say something.
“What did you find?”
“After doing a special test called a flow cytometry, we found evidence of blasts in your peripheral blood.”
“What does that mean?” I asked.
“In your bone marrow, you have stem cells whose job is to become fully functional red cells, white cells or platelets. Blasts are blood cells that don’t mature. They usually die off in the marrow and don’t cause any problems. If, for some reason, they don’t die off, they fill the bone marrow until healthy cells are crowded out. In other words, the bone marrow is failing to do its job,” he replied.
“What does that mean?” I asked again.
“Because there’s the presence of blast cells in your peripheral blood stream you most likely have MDS or AML.”
My stomach felt like I had a hot rock in it. I turned to a blank page in my journal and wrote:
June 8th, most likely MDS or AML.
Before I could ask him to explain the terms, he continued.
“A bone marrow biopsy is the only way to definitively diagnose you. I suspect, since we found 1% circulating blasts in your blood stream, we’ll find a much higher number in your marrow. If the blast percentage is below 19%, the diagnosis is Myelodysplastic Syndrome (MDS). If it’s over 19% it would indicate you’ve already transitioned to Acute Myeloid Leukemia (AML).”
A buzzing started in my ears. My face felt hot.
“Okay, what’s the prognosis?”
It was hard to stay calm and ask rational questions.
“I want to wait until after the results of the biopsy are in because there are many different courses of treatment. It’s all dependent on the blast count and other genetic factors.”
I felt like I was drowning.
“Is there a cure?”
“Stem cell transplant is the best treatment to eradicate this disease. But like any cancer, it could return, depending on many factors,” he responded.
There, he’d said it. The Big C.
“What does a transplant involve?”
“First you’d be given high doses of chemotherapy and maybe some radiation to kill off all the stem cells in your bone marrow. Then those cells would be replaced with some from a suitable donor.”
“That sounds intense,” I replied.
“Let’s not get ahead of ourselves. I’d like to wait until we know more before discussing treatment options. If your blast count is below 5%, you may need less treatment. Do you have any questions?”
I had hundreds of them, but couldn’t form the words. Myelodysplastic Syndrome? Acute Myeloid Leukemia? Bone Marrow Biopsy? Stem Cell Transplant? I saw a lot of “Googling” in my future.
“Tell you what, make a list and bring it with you to your next appointment. I don’t want to wait until the 22nd to do the biopsy at the hospital, so I’d like you to come to my office on Thursday at 4:00pm for the procedure. I know this is a lot to digest, but the sooner we do the biopsy, the quicker I’ll be able to give you some answers.”
No shit!
I hung up the phone and slumped back into my chair. The words I’d written in my journal glared at me.
Most likely MDS or AML.
WTF
Looking out the window I saw Joe sitting in one of the Adirondack chairs by the shore of the river. Our dog, Dasher, sat next to him as they gazed at the water. It broke my heart to think about telling him what the doctor said.
Enjoy the moment my love. I hope you’re ready for this turn of events.
*name is changed for privacy
Have you had a time when your life was abruptly interrupted by a tragedy or diagnosis? If so, what kept you sane?
For me it was writing in my journal, taking long walks with my dog, or sitting by the water listening to a carefully curated playlist.